What is nursing coming to?

FlyingScot, RN · Jun 30, 2011

I got a laminated "script" card at one those lovely staff meetings. I'd been a nurse for about 20 years at that time and really didn't feel the need to have to read from it but was told it was required. I turned in my 2 week notice before the meeting ended. Apparently I didn't "have the time"!

love-d-OR · Jun 30, 2011

Has it not always been that way? I say be active in your state and push for better working conditions, writing on this site is a great way to release the stress, but it won't change a thing! Look at CA where am at, 7 patients on the floor is unheard of. Nurses fought for better staffing and we are enjoying the outcome.

gohogs · Jun 30, 2011

Hospitals are in the money making business

jessica.lanelle · Jun 30, 2011

That sounds like nursing was 8 years ago when I started out, except that I would have cried tears of JOY if I only had four patients on the med surg floor I worked on.

RNAM1965 · Jun 30, 2011

Our hospital does all the things you mentioned in your post, sounds like STuder Group is consulting. I say give it a chance. It has made a huge difference in our hospital on our quality scores and pt satisfaction scores, and huge improvements in the work environment. And yes, I DO care alot about that, because those scores are tied into our reimbursement from Medicaid, Medicare. Hospitals aren't making this stuff up to make nurses miserable. I swear on my father's grave, hourly rounding, et. al has made our unit more organized and it does work when it is done properly. But nurses with bad attitudes that won't give a new idea a try ruin it for everyone.

Just get over it and do it, and expect it from your co-workers too. Or don't , then it will fail, and while there alot of nurses who would derive a sick satisfaction from that failure, this is something that no hospital can afford to fail at. This is a time for nursing to show the administration just how much nursing care drives quality and outcomes and just how valuable our contribution is to the bottom line of the hospital. Just like "Love-d-OR" states, this is the time for nurses to band together as professionals, instead of acting out against every new initiative, and this can be our time to shine. But, nursing seems to be more interested in victim-thinking and self-sabotage. This is why other healthcare professions do not take us seriously. ANd that is a darn shame.

As for the pain med times being posted for patients in their rooms, think about if you are a patient. I have been in the hospital myself and with family members, and guess what? None of the nurses volunteer ANY info about a plan, goals, outcomes or anything, to me (or my family member). I have seen my family, friends suffer in pain because they don't realize how the "prn" thing works and they assume the RN has enough sense to know they are probably in pain and will be offering pain meds if available. Patient satisfaction scores forces caregivers (NOT just nurses!) to pay attention to those things and guess what happens in the process? Outcomes improve. Happens every time, look it up in the literature. I have seen it and believe it. Every hospital with good pt sat scores (good HCAHPS scores) also has good outcomes, quality indicators, etc. So if your hospital does it half-way, it will fail and ultimately the financial health of your hospital will fail. Yes, hospitals are interested in making money. Accept it and embrace it . I , for one, want to have a job and want my hospital to succeed so I can continue to have this job. We put our patient's pain meds and times in the patient rooms too. And alot of nurses said it would encourage the pain med-seekers. Well, it did not. . .and really, why would we punish the rest of the patients because we want to punish the pain-med seekers anyway? I think sometimes we get a bit twisted in our thinking. . .working around constant grumbling and negativity will do that. Nursing is hard, always has been and always will be. But it doesn't have to be miserable. I know because years ago I made a conscious decision to stop being a victim, stop complaining, and start coming up with some solutions to make my work envirnoment more bearable.

And, please remember, that 2 years in nursing is just a drop in the experience bucket. It takes many more years to become truly proficient. Just give this stuff a chance because it is all here to stay. . no matter if you love it or hate it. . . so why not take this opportunity to work with, instead of against, these new practices?

Erie77 · Jun 30, 2011

Hi there everyone; what is nursing coming to? Nursing is a money making joke. Why do I say that? Because the patients do not get the care they deserve and the nurses get treated like dogs and worked to death, and who benefits? The employer only; no one else. Why has it become like this? Because as a whole nurses are mostly women and women for the most part will put up with too much crap and keep on keeping on. We as women need to step up to the plate and think not of just ourselves, but of our patients and Unionize! It is way past time that we should of been brave and done this. What profession is there that is not unionized? Electricians, plumbers, teachers, carpenters, painters... are all unionized, so what is the hold up?

LTV950rn · Jun 30, 2011

Our hospital does all the things you mentioned in your post, sounds like STuder Group is consulting. I say give it a chance. It has made a huge difference in our hospital on our quality scores and pt satisfaction scores, and huge improvements in the work environment. And yes, I DO care alot about that, because those scores are tied into our reimbursement from Medicaid, Medicare. Hospitals aren't making this stuff up to make nurses miserable. I swear on my father's grave, hourly rounding, et. al has made our unit more organized and it does work when it is done properly. But nurses with bad attitudes that won't give a new idea a try ruin it for everyone.
Just get over it and do it, and expect it from your co-workers too. Or don't , then it will fail, and while there alot of nurses who would derive a sick satisfaction from that failure, this is something that no hospital can afford to fail at. This is a time for nursing to show the administration just how much nursing care drives quality and outcomes and just how valuable our contribution is to the bottom line of the hospital. Just like "Love-d-OR" states, this is the time for nurses to band together as professionals, instead of acting out against every new initiative, and this can be our time to shine. But, nursing seems to be more interested in victim-thinking and self-sabotage. This is why other healthcare professions do not take us seriously. ANd that is a darn shame.
As for the pain med times being posted for patients in their rooms, think about if you are a patient. I have been in the hospital myself and with family members, and guess what? None of the nurses volunteer ANY info about a plan, goals, outcomes or anything, to me (or my family member). I have seen my family, friends suffer in pain because they don't realize how the "prn" thing works and they assume the RN has enough sense to know they are probably in pain and will be offering pain meds if available. Patient satisfaction scores forces caregivers (NOT just nurses!) to pay attention to those things and guess what happens in the process? Outcomes improve. Happens every time, look it up in the literature. I have seen it and believe it. Every hospital with good pt sat scores (good HCAHPS scores) also has good outcomes, quality indicators, etc. So if your hospital does it half-way, it will fail and ultimately the financial health of your hospital will fail. Yes, hospitals are interested in making money. Accept it and embrace it . I , for one, want to have a job and want my hospital to succeed so I can continue to have this job. We put our patient's pain meds and times in the patient rooms too. And alot of nurses said it would encourage the pain med-seekers. Well, it did not. . .and really, why would we punish the rest of the patients because we want to punish the pain-med seekers anyway? I think sometimes we get a bit twisted in our thinking. . .working around constant grumbling and negativity will do that. Nursing is hard, always has been and always will be. But it doesn't have to be miserable. I know because years ago I made a conscious decision to stop being a victim, stop complaining, and start coming up with some solutions to make my work envirnoment more bearable.
And, please remember, that 2 years in nursing is just a drop in the experience bucket. It takes many more years to become truly proficient. Just give this stuff a chance because it is all here to stay. . no matter if you love it or hate it. . . so why not take this opportunity to work with, instead of against, these new practices?

It seems like you're missing the point. I get what you are saying, but with 7 patients with HIGH needs? That's unreasonable. The staffing ratios need to come down to be able to do everything the OP mentioned she needs to get accomplished. The hourly rounding is a good idea, but again, with 7 patients, how are you supposed to spend any time checking on your patients and attending to basic needs (ie, bathroom, hygiene, etc), much less getting necesssary meds and treatments, answering questions, dealing with family members, etc, in when you have less than 10 minutes an HOUR to be able to accomplish it? How is the nurse even supposed to take care of herself by using the bathroom, drinking a glass of water, or even taking (*gasp*) a break once during her shift? Your attitude almost suggests you are in administration yourself. If not, I'm amazed how quick you are to jump down this person's throat and tell her to just deal with it. Insulting her "mere" 2 years of experience is insulting as well. Bedside nursing has changed significantly over the past few decades and administration cares for nothing more than profit and to pat themselves on the back. They don't care about nurses at all.

And people wonder why I sacrifice less pay for the opportunity to work 1:1 in private duty. I don't ever have a desire to work in a hospital settting for all the reasons OP has mentioned. My job has it's cons, but at the end of the day, I know I left giving my patient the best possible care I can. I don't feel I could ever truly do that in a hospital unless something significantly changes.

KSU-SN · Jun 30, 2011

I understand that the hospital is a money making business and yes I want my hospital to profit. But more importantly I want SAFE care for my patients and I dont want to kill myself trying to give them safe care. Having 7 high acuity patients is not safe. It is taxing my mind and body and I am only 25 years old. I am more than happy to do all the things administration wants me to do to bring up patient satisfaction if they would just give us more help!! Why cant they see that patients would get better care if we had more staff??? They are paying us overtime to stay over 2-3 hours to finish our charting when they could have just given us an extra RN or another aide and everyone could get out on time, the patients are happy, and the staff is happy. Im not saying that more staff would solve all the problems and the patients would always be satisfied but it will definitely help! I constantly feel rushed when im with my patients and thats not only unsafe but the patients can sense it and its unfair to them that they arent getting their emotional and physical needs met. It seems like administration keeps giving us more and more things to do but our shifts arent any longer and we sure arent getting more help!!

doomsayer · Jun 30, 2011

And TONS of new grads hungry for work.

tsk, tsk :)

linearthinker, DNP, RN · Jun 30, 2011

My suggestion to you is to join the ANA and your state Nsg Association. Get acquainted with your state and congressional representatives and senators; let them hear from you at least monthly. Read the literature and be able to support your position with regard to patient safety with facts and figures, hard data. Support PACs (financially) that represent your professional interests. Become well acquainted with your state BON reps. Attend BON meetings. Consider running for a BON position if you do not think you are well represented. Speak, write, network, advocate.

Or just keep b!tching to the choir and see how well that works for you.

nurse2033, MSN, RN · Jun 30, 2011

You are right, it is not possible to meet all these demands.